Individual provider Active NPI

Gina Fidler, NP

  • Family Nurse Practitioner
  • Denver, CO
National Provider Identifier
1265965982
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0993132-NP Issued in CO
Practice address
1076 S Gaylord St
Denver, CO 80209-4636
Phone
(720) 923-2344
NPI assigned
Apr 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.1625437 CO
Family Nurse Practitioner 363LF0000X 0993132-NP CO Primary

Addresses

Primary practice location

1076 S Gaylord St
Denver, CO 80209-4636

Mailing address

669 S Corona St
Denver, CO 80209-4405
Phone (303) 990-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170628001772 CO Practitioner - Nurse Practitioner 7416226832 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.1625437COMDRegistered Nurse
0993132-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wash Park Health Family CurrentSince Oct 22, 2023 Accepting new patients
Advanced Integrative Medicine PC CurrentSince Apr 13, 2019 Accepting new patients

Locations

1076 S Gaylord St
Denver, CO 80209
Phone (303) 722-0367

10455 Park Meadows Dr
Bldg 1
Lone Tree, CO 80124
Phone (303) 708-0246

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1265965982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 S CORONA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802094405",
            "telephone_number": "303-990-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 S GAYLORD ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802094636",
            "telephone_number": "720-923-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDLER",
        "first_name": "GINA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.1625437",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0993132-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.